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The routine application of preoperative percutaneous transhepatic biliary drainage (PTBD) to patients who have obstructive jaundice has a significant effect on overall morbidity, mortality, and patient survival by allowing selective application of the most appropriate therapeutic modality. Surgical patients who undergo PTBD were compared with those for whom PTBD was not available. The surgical complication rate was 44% for those who did not undergo PTBD and 15% for those who did. The surgical procedure-related mortality rate was 30% for those who did not undergo PTBD and 12% for those who did. These differentials may have been due either to a beneficial effect of presurgical decompression or to the fact that only more favorable candidates were selected for operative internal bypass. There was an overall increase in length of survival following the application of PTBD, especially in those patients who were surgical candidates.

A case of foramen of Morgagni hernia (partial eventration of the right diaphragm) containing liver was diagnosed by hepatic scintiphotography. Diagnostic pneumoperitoneum has been recommended as the procedure of choice in the past. It is suggested that this be replaced by liver scaning. The similarity between eventration of the right diaphragm and foramen of Morgagni hernia is discussed.

Increased concentration of technietum was noted in the region of the frontal, ethmoidal, and maxillary sinuses of two patients. Radiographs of the sinuses revealed extensive sinusitis involving the sinuses in the area of increased uptake. The increased uptake was attributed to the sinusitis.